Thank you, and good afternoon, Madam Chair. It is my pleasure to address the committee as part of its monitoring of the situation related to the supply of medical isotopes.
As a family physician, I am not an expert in nuclear medicine, but I do refer patients for diagnostic and treatment services that require the use of medical isotopes.
First and foremost, I want to note that the CMA is proud of the efforts and dedication of health care providers from across the country who have stepped up to meet patients' needs during this ongoing stressful and demanding time. Through their concerted efforts and those of the industry and governments, the system appears to be coping. Patients are receiving needed diagnostic and treatment services, either through radiopharmaceutical models or their alternatives. However, there are reports of sporadic adverse events, as has been the case since the beginning of this situation. These include delays of 48 to 72 hours and suboptimal imaging due to the extensive use of thallium-201 rather than technetium-99m, which is in short supply.
The CMA and representatives from the nuclear medicine community continue to work with Health Canada to mitigate the impact of the shortage of medical isotopes. Scheduling appropriate care commensurate with the expected supply of isotopes has been aided by the efforts of Lantheus and Covidien, suppliers of generators and radiopharmaceuticals who regularly share vital production information with the nuclear medicine community. This has improved communications and allowed for the better predictability of supply than had been the case last May and June.
Lest you interpret my comments to mean all is well, let me be clear. Much is being done, but the current situation is neither optimal nor sustainable, and there appears to be no long-term plan. Canada's physicians are concerned about the toll the current shortage of isotopes is taking on the health care system as a whole. In particular, the resulting increased demand on resources, both human and financial--and especially now in the midst of a pandemic--is not sustainable. Therefore, we have called upon governments to invest in a five-year action plan that includes an emergency fund to increase the use of positron emission technology and the production of associated radiopharmaceuticals across Canada.
At our annual meeting this August, Canada's physicians expressed their concern by passing a series of motions calling for government action. This action included demands that the federal government retain Canada's leadership and ability to produce and export medical isotopes and reconsider its decision to withdraw from their production. The motions also called for the appointment of an international independent expert panel to thoroughly assess the decision to abandon the MAPLE 1 and MAPLE 2 nuclear reactors at Chalk River and promptly release the conclusions and recommendations of the panel to the public.
Our delegates also demanded that the federal government conduct open, meaningful, and ongoing consultations with nuclear medicine physicians and their respective national associations on any and all federal decisions directly affecting the supply of medical isotopes. Concern was expressed that decisions have been and will continue to be made for political and financial expediency without taking into account the medical ramifications of those decisions.
We appreciated having the opportunity to participate in discussions with the Expert Review Panel on Medical Isotope Production appointed by the Minister of Natural Resources. While it is anticipated the panel will report to the minister by the end of this month, we do not know when that report will be made public and how long it will take to move recommendations to action.
Canadian physicians also urge the federal government to immediately invest in research in basic and clinical science to find viable alternative solutions to the production and use of technetium-99m. The announcement of $6 million for research into alternatives to medical isotopes through a partnership between the Canadian Institutes of Health Research and the Natural Sciences and Engineering Research Council of Canada is a good start. We must emphasize that bench-to-bedside research is critical. There must be a clinical translation of new technology to the provision of care.
To conclude, the CMA remains concerned about health care providers and the health care system's ability to sustain the current shortage, Canada's ability to ensure a long-term stable and predictable supply of medically necessary isotopes, and our lack of contingency planning for the next shortage. The CMA will continue to work with all involved to ensure Canadians have access to the best possible care and treatment.